Follow-Up of Patients Who Achieved Sustained Virologic Response after Interferon-Free Treatment against Hepatitis C Virus: Focus on Older Patients

Nirei, Kazushige; Masuzaki, Ryota; Mizutani, Taku; Moriyama, Mitsuhiko

doi:10.3390/medicina57080761

Cited by 5 publications

(8 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…EZR is freely available at (http://www.jichi.ac.jp/saitama-sct/SaitamaHP. files/statmed.html, accessed on 1 December 2021), which is a modified version of R commander, designed to add frequently used statistical functions in biostatistics [16,17].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Left Gastric Vein Width Is an Important Risk Factor for Exacerbation of Esophageal Varices Post Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices in Cirrhotic Patients

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background and Objectives: Balloon-occluded retrograde transvenous obliteration (BRTO) could be currently one of the best therapies for patients with gastric varices. This study examined the exacerbation rates for esophageal varices following BRTO for gastric varices in patients with hepatic cirrhosis. Materials and Methods: We enrolled 91 cirrhotic patients who underwent BRTO for gastric varices. In total, 50 patients were examined for exacerbation rates of esophageal varices following BRTO. Esophageal varices and their associated exacerbation were evaluated by upper gastrointestinal endoscopy. Patients were allocated into two groups according to the main inflow tract for gastric varices: (1) 36 patients in the left gastric vein (LGV) group with an LGV width of more than 3.55 mm, and (2) 14 patients in the non-LGV group who had short gastric vein or posterior gastric vein. Moreover, treatment outcomes were retrospectively analyzed. Results: LGV width (p < 0.01) was the major risk factor for the deterioration of esophageal varices post BRTO. In addition, LGV was the most common inflow tract, and the LGV group contained 74% (37/50) of patients. The exacerbation rates of esophageal varices at 1, 2, 3, and 4 years post BRTO were 40%, 62%, 65%, and 68%, respectively. The comparison of the exacerbation rates for esophageal varices following BRTO according to inflow tract showed that the exacerbation rates were significantly higher in the LGV group than those of the non-LGV group (p = 0.03). In more than half of the subjects, LGV was the main inflow tract for gastric varices, and this group experienced more frequent exacerbations of esophageal varices following BRTO compared to patients with different inflow tract sources. Conclusion: Careful attention should be paid to the LGV width when BRTO is performed for gastric varices.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Hepatitis B virus (HBV) surface antigen (HBsAg) and anti-hepatitis C virus (HCV) antibodies were also measured in all patients. Diagnosis of cirrhosis and/or hepatocellular carcinoma was previously described [16].…”

Section: Laboratory Testsmentioning

confidence: 99%

Left Gastric Vein Width Is an Important Risk Factor for Exacerbation of Esophageal Varices Post Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices in Cirrhotic Patients

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Spontaneous negativation of serum HCV RNA is a rare event in chronic HCV infections (11). As eradication of HCV could recover immune homeostasis to the HCV uninfected status, it could be useful to improve liver function and prevent the occurrence of hepatocellular carcinoma (HCC) (12,13). Because DAA treatment for chronic HCV infection could also lead to dynamic immunological changes (12), attention should be paid to the occurrence of HCC and HBV reactivation immediately after treatment with DAA (14,15).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 After Treatment With Direct-acting Antivirals for HCV Infection and Decompensated Cirrhosis: A Case Report

Ikegami

Kanda

Ishii

et al. 2022

In Vivo

Self Cite

View full text Add to dashboard Cite

Background: Eradication of hepatitis C virus (HCV) from chronic HCV-infected patients could improve liver function and prevent hepatocarcinogenesis in the long term. Eradication of HCV by direct-acting antivirals (DAAs) also leads to dynamic immunological changes. We report a case of recurrent coronavirus disease 2019 that developed immediately after combination treatment with DAAs for HCV infection and decompensated cirrhosis. Case Report: A 55-year-old male was started on a 12-week treatment with combination of HCV NS5A inhibitor velpatasvir and HCV NS5B polymerase inhibitor sofosbuvir. HCV RNA became undetectable after six weeks of treatment and was undetectable at the end of the treatment (EOT). Twelve days after the EOT, we diagnosed the patient with COVID-19 pneumonia, admitted him to our hospital and he was discharged two weeks later. One week after his discharge, he visited our hospital again, was diagnosed with recurrent COVID-19 pneumonia readmitted for a second time. Four days after second admission, cardiac arrest occurred, however, he recovered from severe COVID-19 and achieved sustained virological response and his liver function improved. Conclusion: In the COVID-19 era, while attention should be paid to the occurrence or exacerbation of infection, including COVID-19, interferon-free DAA combination therapy should be performed for HCV-infected individuals.Patients with decompensated cirrhosis experience at least one episode of ascites, jaundice, hepatic encephalopathy, or variceal bleeding (1). The 5-year survival rate after the onset of decompensation is 50% in patients with hepatitis C virus (HCV) infection and compensated cirrhosis (2). Interferon-free direct-acting antiviral agent (DAA) combination therapy is available for patients with HCV infection and decompensated cirrhosis (3). Interferon-free DAA combination therapy could result in ~90% sustained virological response (SVR) rates even if patients with HCV infection had decompensated cirrhosis (3). In the coronavirus disease 2019 (COVID-19) era, clinicians are occasionally concerned about whether HCVinfected patients should be treated by DAA combination therapy.COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread in Japan and worldwide (4, 5). As of January 23, 2022, global cumulative COVID-19 confirmed cases and deaths reported by World Health Organization were 346,741,628 and 5,584,374, respectively (6).Liver injury is often observed in COVID-19 patients. The mechanism of liver dysfunction in COVID-19 patients includes direct cytopathic effects of SARS-CoV-2, immune reaction and cytokine storm-related multiorgan failure, hypoxia-reperfusion dysfunction, and drug-induced liver injury due to the various drugs used for COVID-19 treatment (7). SAR2-CoV-2 has a high affinity for angiotensinconverting enzyme 2 receptors, which are also expressed in the liver (8).1986

show abstract

Section: Methodsmentioning

confidence: 99%

“…Patients on dialysis and those with severe chronic kidney disease (CKD) or those with a history of curative HCC treatment were included. Some of these patients had been included in other studies[6,12].The protocol of this single center study followed the Declaration of Helsinki. The ethics committee of Nihon University School of Medicine Itabashi Hospital approved this retrospective study (protocol number RK-181009-04, and RK-180911-12).…”

mentioning

confidence: 99%

Efficacy of Glecaprevir/Pibrentasvir for Real-World HCV Infected Patients in the Northern Part of Tokyo, Japan

Yamana

Matsumoto

Honda

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

Hepatis virus C (HCV) infection causes liver cirrhosis and hepatocellular carcinoma (HCC) worldwide. The objective of our study was to examine the effects of the HCV nonstructural protein (NS) 3/4A inhibitor glecaprevir/NS5A inhibitor pibrentasvir on real-world HCV patients in the northern part of Tokyo, Japan. Although 106 patients were consecutively included, a total of 102 HCV-infected patients with chronic hepatitis or compensated cirrhosis, who received 8- or 12-week combination treatment with glecaprevir/pibrentasvir and were followed up to week 12 after the end of treatment were analyzed retrospectively. Only three patients discontinued treatment due to adverse events; however, they achieved a sustained virologic response at 12 weeks (SVR12). Finally, SVR rates were 99.0% (101/102). Only one patient without liver cirrhosis was a treatment relapser who received hepatic resection for HCC approximately two years after commencement of the 8-week combination treatment with glecaprevir/pibrentasvir. After the exclusion of patients with HCV genotype 1b and P32 deletion in the HCV NS5A region, a 12-week combination of glecaprevir/pibrentasvir led to SVR12 in all nine direct-acting antiviral-experienced patients. Glecaprevir/pibrentasvir had a high efficacy and an acceptable safety profile for real-world HCV patients in a single hospital in Japan.

show abstract

Follow-Up of Patients Who Achieved Sustained Virologic Response after Interferon-Free Treatment against Hepatitis C Virus: Focus on Older Patients

Cited by 5 publications

References 32 publications

Left Gastric Vein Width Is an Important Risk Factor for Exacerbation of Esophageal Varices Post Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices in Cirrhotic Patients

Left Gastric Vein Width Is an Important Risk Factor for Exacerbation of Esophageal Varices Post Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices in Cirrhotic Patients

COVID-19 After Treatment With Direct-acting Antivirals for HCV Infection and Decompensated Cirrhosis: A Case Report

Efficacy of Glecaprevir/Pibrentasvir for Real-World HCV Infected Patients in the Northern Part of Tokyo, Japan

Contact Info

Product

Resources

About